Journal article
Effect of evidence-based acute pain management practices on inpatient costs
Health services research, Vol.44(1), pp.245-263
02/01/2009
DOI: 10.1111/j.1475-6773.2008.00912.x
PMID: 19146567
Abstract
Objectives: To estimate hospital cost changes associated with a behavioral intervention designed to increase the use of evidence-based acute pain management practices in an inpatient setting and to estimate the direct effect that changes in evidence-based acute pain management practices have on inpatient cost.
Data sources/study setting: Data from a randomized "translating research into practice" (TRIP) behavioral intervention designed to increase the use of evidence-based acute pain management practices for patients hospitalized with hip fractures.
Study design: Experimental design and observational "as-treated" and instrumental variable (IV) methods.
Data collection/extraction methods: Abstraction from medical records and Uniform Billing 1992 (UB92) discharge abstracts.
Principal findings: The TRIP intervention cost on average $17,714 to implement within a hospital but led to cost savings per inpatient stay of more than $1,500. The intervention increased the cost of nursing services, special operating rooms, and therapy services per inpatient stay, but these costs were more than offset by cost reductions within other cost categories. "As-treated" estimates of the effect of changes in evidence-based acute pain management practices on inpatient cost appear significantly underestimated, whereas IV estimates are statistically significant and are distinct from, but consistent with, estimates associated with the intervention.
Conclusions: A hospital treating more that 12 patients with acute hip fractures can expect to lower overall cost by implementing the TRIP intervention. We also demonstrated the advantages of using IV methods over "as-treated" methods to assess the direct effect of practice changes on cost.
Details
- Title: Subtitle
- Effect of evidence-based acute pain management practices on inpatient costs
- Creators
- John M BrooksMarita G TitlerGail ArderyKeela Herr
- Resource Type
- Journal article
- Publication Details
- Health services research, Vol.44(1), pp.245-263
- DOI
- 10.1111/j.1475-6773.2008.00912.x
- PMID
- 19146567
- NLM abbreviation
- Health Serv Res
- ISSN
- 0017-9124
- Language
- English
- Date published
- 02/01/2009
- Academic Unit
- Nursing
- Record Identifier
- 9983557478702771
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